Technique: Heart Sounds &
Murmurs

Using the Stethoscope

A modern stethoscope consists of two earpieces connected by tubing to a chest piece which usually has both diaphragm and bell attachments. Earpieces should be angled forwards to match the direction of the practitioner's external auditory meati.

The bell is used to hear low-pitched sounds. Use for mid-diastolic murmur of mitral stenosis or S3 in heart failure.

The diaphragm, by filtering out low-pitched sounds, highlights high-pitched sounds. Use for analyzing the second heart sound, ejection and midsystolic clicks and for the soft but high-pitched early diastolic murmur of aortic regurgitation.